Mr. President, What Will Be Done About the AIDS Issue?

A lot change took place as Barack Obama took the oath of office and became the 44th president of the United States. A lot of those changes have gotten a lot of press, but many wonder what effect this change of leadership will have on U.S. AIDS policy. While President Bush has been very generous in international support of AIDS education and treatment, it seems likely AIDS policy will have a stronger focus here at home under a President Obama.

Bush leaves a legacy praised at times by even his harshest critics of providing massive amounts of funding to African and other undeveloped nations to enable even the poorest of the poor to have access to live-saving anti retroviral drugs. Dubbed the United States President’s Emergency Plan for AIDS Relief, or PEPFAR. Look, when even Sen. John Kerry praises Bush’s efforts in this regard, you know he’s done something right.

PEPFAR has enabled about 1.4 million AIDS patients to receive medications they previously would have had no access to. The only truly controversial aspect of the program has been the requirement that a third of the funding ($19 billion so far) be used for abstinence-only education. That’s what the program calls the ABC (Abstain, Be faithful and correct and consistent use of Condoms) approach. But the program also focuses on mother-to-child transmission, the safety of the blood supply, safe medical injections, male circumcision, IV drug use and other issues.

That’s not to say Obama won’t continue the good work internationally.

Obama says he would reauthorize PEPFAR, though he wants rewrite “significant portions” to take ideology out of the equation - obliquely referring to ABC (you can download a PDF of Obama’s stance on the issue here). He also wants to increase the U.S. contribution to The Global Fund. He traveled to Kenya with his wife, Michelle, in 2006 and took an AIDS test to encourage African men and women to be tested for the disease.

But Obama has laid out an ambitious policy program for fighting HIV/AIDS here at home, outlining these major points:
• Develop and begin implementation of a national HIV/AIDS strategy across all federal agencies, within the first year of his presidency.
• Fix the nation’s healthcare system so the 47 million or so uninsured get proper access to affordable healthcare, within his first term.
• Hone in on the disproportionate effect AIDS has on minority communities, in part by tackling poverty and homelessness.
• Promoting “innovative HIV/AIDS testing initiatives in minority communities,” including partnerships with a variety of organizations, from “churches to community organizations.”
• Increase funding for research, particularly in the search for a vaccine.
• Promote prevention.
• Expand HIV testing options for pregnant women.

Among the U.S. programs Obama wants to support and fund are:
• The Ryan White Care Act, which helps more than half a million low-income people with HIV/AIDS get access to treatment and support.
• The JUSTICE Act, which works to prevent HIV transmission in the prison population.
• Legislation to lift the ban on federal funding for needle exchange.
• Housing Opportunities for People with AIDS (HOPWA) and other related housing programs, to ensure disabled and low-income people with HIV/AIDS have access to “adequate and safe housing.”

While the worldwide community that fights HIV/AIDS has a lot to thank President Bush for, there is cause to be encouraged by incoming President Obama.